NUR 213 Final Exam Review

If a pt. sustains and electrical burn what is the first thing you should do? - Remove pt from source. What is anthrax, plague and tularemia treated with? - Antibiotics How is botulism treated? - Antitoxin What is sarin? - (powder) toxic nerve gas that can cause death w/n minutes of exposure, enters body through eyes & skin, acts by paralyzing resp. muscles What are antidotes for nerves agents? - Atropine, pralidoxime chloride What is phosgene? - Colorless gas, if inhaled @ high concentration for long enough period, causes severe resp. distress, pulmonary edema, and death What is mustard gas? - Yellow to brown in color with garlic-like odor, irritates eyes & causes skin burns/blisters What are radiological dispersal devices? - 'Dirty bombs', explosives & radioactive material. What is the RED tag criteria? - Critically injured, with problems requiring immediate intervention (EMERGENT), RR >30, or RR<30 & cap refill >2 seconds or if cap refill <2 seconds - assess mental status (CANNOT follow simple commands)What is the criteria for the yellow tag? - Urgent; injured & will require medical attention bt will not die if care is delayed, not ambulatory, needs stretcher for transport, CAN follow simple commands What is the criteria for green tag? - Ambulatory, not critically injured, walkie talkie, have them walk to safe place What is criteria for black tag? - Expectant/dead, deceased or not expected to live, if pt not breathing, open airway manually, if pt cont. to be apneic = TAG BLACK What should you tag a pt, if they are apneic on arrival but after manually opening airway the pt begins to breathe? - RED Rule of Nines- what is the % for torso & back? - 18% each Rule of Nines - what is the % for arms & head? - 4.5% each Rule of Nines- What is the % for the legs? - 9% each If a pt sustains a chemical burn what is the first thing you should do? - Brush solid particles off the skin & use water lavage If a pt sustains a small thermal burn what is the first thing you should do? - Cover w/ clean, cool, tap water- dampened towel If a pt sustains a large thermal burn what is the first thing you should do? - Assess ABCs, DO NOT immerse in cool water or pack w/ ice, remove burned clothing, wrap in clean, dry sheet or blanket.If a pt sustains a inhalation injury what is the first thing you should do? - Observe for s/s of resp. distress or compromise. Burn complications - hypovolemia, infection, compartment syndrome, edema, AMS, Adynamic ileus, blisters, dysrhythmias, tissue ischemia, necrosis, sludging, airway obstruction, renal ischemia, acute tubular necrosis What is the Parkland Baxter formula? - 4ml * TBSA% * wt. in kg ARDS etiology - Develops from a variety of direct or indirect lung injuries. Causes low blood oxygen; fluids builds up inside the tiny air sacs of the lungs & surfactant breaks down. Most common cause is sepsis. 1st symptoms is usually S.0.B.; main tx: supplemental O2 S/S of low O2 levels in a ARDS pt - Dyspnea, tachypnea, restlessness, diaphoresis, cyanosis, pallor, hypoxemia despite increased FIO2, blue finger tips or tone of skin; chest auscultation may reveal normal of fine scattered crackles; increased work of breathing; "white out" chest x-ray Interventions for ARDS - O2 administration (BiPAP, CPAP, mech. vent), proning, maintenance of nutrition/fluid intake, acid-reducing meds, blood transfusion (low HGB), ECMO, ABX, blood thinners, muscle relaxants, pain meds, sedatives, & PT (prevent contractures/ulcers) S/S of bacterial meningitis - High fever, nuchal rigidity, severe headache, postive Brudzinski sign, positive Kernig's sign, AMS (stupor, drowsiness, delirium), diplopia, photophobia, petechiae on trunk, extremities & mucous membranes